A national long-term care coalition gave an update Tuesday on their action plans to address the fundamental issues facing the LTC sector.

Highlighted were plans for a new pilot for a nurse aide apprenticeship program, tools to strengthen resident councils, and meetings to raise awareness of facility renovation needs.

The Moving Forward Nursing Home Quality Coalition was formed in the wake of a 2022 report from the National Academies of Sciences, Engineering, and Medicine that industry leaders described as a wake-up call. 

The coalition of providers, residents, advocates and policymakers set out to develop actionable methods to fix the major issues, resulting in a nine-part plan they announced in July 2023. 

During Tuesday’s webinar, coalition leaders spent the most time focused on staffing issues. Coalition Chair Alice Bonner put a spotlight specifically on certified nursing assistants.

She referenced the struggles that nursing homes nationwide have had with retaining their workforce, including CNAs. 

“Across the country, CNAs are not well paid, they don’t get good benefits,” she pointed out. “We need to do something about that.”

Beyond simply offering higher wages and benefits, though, Bonner stressed the need to create a standardized career path for CNAs. 

More depth to training

She referenced a National Association of Health Care Assistants survey that asked CNAs who were thinking about leaving the industry what could keep them at their jobs. Better wages and benefits topped the list, but better training was a major factor as well.

“People really do want those additional skills,” Bonner said, “they want that additional training, and they want to get compensated after that.”

She noted that state and federal apprenticeship programs already exist for CNAs, but also that those resources lack the standardization that Moving Forward advocates for. 

“A lot of what we’ve learned is that there’s such variability and fragmentation. It’s not that these programs don’t exist — they absolutely exist — but some states have way more structure than other states.”

To address this, the coalition proposes that a national CNA apprenticeship program should be created with the specific goals of providing training that can be reliably replicated at the state level and providing skills and certifications that can be taken and applied in jobs around the country.

Moving Forward plans to pilot an apprenticeship program with at least two nursing homes by July of 2024 and leverage that momentum to advocate with policymakers at the state and federal level. 

“[CNAs] are the heart and the soul of the nursing home workforce and they spend the greatest number of hours everyday with residents. They know things about residents that nobody else does,” Bonner said. “They are a critical member of the interprofessional team and they really need to be recognized in a different way than they are.”

Resident councils and renovations

Other presenters took turns describing the progress Moving Forward is making on two other areas of their nine-part plan. 

Sumire Maki, program manager for Moving Forward, laid out the group’s progress on strengthening resident councils, including drafting a guide with tools that nursing homes can use to amplify the voices of their residents. Moving Forward also plans to test some of these methods in a four-facility pilot program starting in January 2024 in New Jersey. 

​​“Resident councils center resident voices and are truly a vital part of community life,” Maki said.

Isaac Longobardi, director of the coalition, also updated attendees on how the coalition is working to make renovations viable for nursing homes that want to create a more home-like atmosphere. They are in the process of partnering with state and federal policymakers on the issue. 

Next week, Moving Forward is meeting with the Department of Housing and Urban Development to discuss actionable steps that could be taken to incentivize renovations in the short term. 

At the state level, Longobardi said the coalition is meeting with policymakers from several states to make them aware that these renovations are a key part of improving resident experiences. Currently, awareness is low, he said.

“We need to make these changes part of state priorities overall in order to drive those changes,” he said.

The event was hosted by Gray Panthers NYC as part of the Transformation Tuesday series. A full recording of the webinar can be found here.